Provider Demographics
NPI:1750467346
Name:STOYKOVICH, JOAN (PA-C, RNP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:STOYKOVICH
Suffix:
Gender:F
Credentials:PA-C, RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8722 ROOSEVELT CIR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-3848
Mailing Address - Country:US
Mailing Address - Phone:714-826-9436
Mailing Address - Fax:714-826-9436
Practice Address - Street 1:1215 E CHAPMAN AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2237
Practice Address - Country:US
Practice Address - Phone:714-633-4600
Practice Address - Fax:714-633-1412
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA11624363AS0400X, 363AM0700X
CA282419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWNP2135AMedicare ID - Type UnspecifiedNURSE PRACTITIONER